AB0224 CORONARY CALCIUM, CAROTID SUBCLINICAL ATHEROSCLEROSIS AND CAROTID STIFFNESS AS PREDICTORS OF ALL-CAUSE MORTALITY AND CARDIOVASCULAR EVENTS IN PATIENTS WITH RHEUMATOID ARTHRITIS: A 10-YEAR PROSPECTIVE FOLLOW-UP STUDY.
Authors: C. Corrales-Selaya, N. Vegas-Revenga, J. A. Parra Blanco, V. Portilla, R. Blanco, M. A. González-Gay, I. Ferraz-Amaro, A. Corrales
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The risk of mortality is increased in patients with RA compared to the general population. Different non-invasive surrogate markers of atherosclerosis have been implemented to identify RA patients who are at high risk of cardiovascular (CV) disease. <h3>Objectives</h3> In the present study, we aimed to establish the predictive capacity of the following surrogate markers: Coronary calcium (CAC), carotid ultrasonography (US), and pulse wave velocity (PWV) to predict CV events and all-cause mortality in a cohort of RA patients prospectively followed. <h3>Methods</h3> We conducted a prospective longitudinal study that included 126 patients with RA. The patients were recruited in 2011 and followed-up for 10 years. All patients had undergone baseline CAC score, evaluation of subclinical carotid atherosclerosis by US, and PWV. Multivariate Cox regression analysis was performed to identify the predictive ability of these surrogate markers for CV events and all-cause mortality. <h3>Results</h3> After a follow-up of 14.479 person (p)/months (m), 15 deaths (incidence rate -IR- 0.001 p/m) and 24 CV events (IR 0.001 p/m) in 18 RA patients were recorded. The causes of mortality in decreasing order of frequency were infections 7 (47%, IR 0.012 p/m), malignancies 5 (33%, IR 0.011 p/m) and others 3 (20%). To our surprise, none of the recorded deaths was from CV causes. The main results of the study are summarized in <b>Table 1</b>. After multivariate analysis, CAC score was associated with a significantly increased risk of CV events. When the CAC score was stratified into different categories, CAC&gt;400 showed an increased risk of CV events on univariate analysis. However, this association was lost after adjustment. Carotid plaque and intima media thickness and PWV did not show a significant association with CV events. Regarding any-cause of death, CAC score, carotid plaque and PWV showed an association with higher risk of mortality. However, they were lost after adjustment for traditional CV risk factors. <h3>Conclusion</h3> Infections and malignancies were the most common cause of mortality in RA after a 10-year prospective follow-up study. CAC score, but neither carotid plaque nor PW, was significantly associated with increased risk of CV events at 10 years. <h3>References</h3> [1] Wang S et al. J Intern Med. 2009 Nov;266(5):445–52. [2] Gonzalez-Gay MA, et al. Semin Arthritis Rheum. 2008 Oct;38(2):67-70 [3] Kerekes G, et al. Nat Rev Rheumatol. 2012 Feb 21;8(4):224-34. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Cristina Corrales-Selaya: None declared, Nuria Vegas-Revenga: None declared, Jose Antonio Parra Blanco: None declared, Virginia Portilla: None declared, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Lilly, Bristol-Myers, Janssen, Galapagos and MSD, Consultant of: Abbvie, Pfizer, Roche, Lilly, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD, Novartis and Roche, Miguel A González-Gay Speakers bureau: Abbvie, Pfizer, Roche, Sanofi, Lilly, Amgen, and MSD., Grant/research support from: Abbvie, MSD, Jansen, and Roche, Iván Ferraz-Amaro Speakers bureau: Abbott, Pfizer, Roche, Sanofi, Celgene and MSD, Grant/research support from: Abbott, MSD, Jansen and Roche, Alfonso Corrales: None declared.